| NPI | 1649366790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WI 6471015) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OH 30022336) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2010-03-11 |